People get knee replacements because
of osteoarthritis, post-traumatic arthritis, rheumatoid arthritis, and other
inflammatory arthritis such as gout. When
a damaged knee impacts everything you do (even getting out of a bed or up and
down stairs) you may have to consider knee replacement. Knee replacement
means you’ve opted to replace your joint with an artificial one. It’s only an
option when all other treatments (pain medicines or injections) can no longer
relieve your pain. The pain results from lost or damaged cartilage that
cushions the bones of the knee.
The surgery itself, involves
replacing some of the damaged bone and cartilage in the joint with a smooth
gliding surface made of metal and plastic. Knee replacements can be either
partial or total. The knee is divided into three compartments: the medial
(inside), the lateral (outside), and the anterior (kneecap). Patients can get
opt for partial replacement when only one part of the knee’s cartilage is
damaged (usually the medial). Most replacements are total because arthritis
tends to affect the entire knee.
While the surgery itself can be
accomplished between 30 to 60 minutes, with prep time and anesthesia the
patient’s time comes out closer to two hours. Surgical anesthesia will include:
a spinal anesthetic (this numbs the legs during the surgery and for several
hours after), a local anesthetic (at the knee), and the use of a “nerve block,” which
can extend pain relief into the days that follow. Pain after a partial knee
replacement is much less severe, and a nerve block may not be given.
Recovery is a year-long process that
occurs in three phases:
·
The first six weeks- Heal, reduce swelling, and regain
movement.
·
The next three to five months-Build endurance and muscle strength
through regular-life activity and exercise.
·
The final six months-Continue to gain strength and
mobility.
Congratulations
on your new knee. You’re one of 600,000 Americans who get a knee joint replaced
every year. You may be thrilled to walk again without pain or no longer face
staircases with dread. Knee replacement is one of the most
satisfying surgeries in orthopedics. The best case scenario involves a
functional joint that remains pain-free for upwards of 30 years. Your new knee may
click and pop. That’s the sound of the metal and plastic in your implant
rubbing against each other. If it doesn’t hurt, you don’t need to worry. You
might have trouble kneeling. Bending down won’t harm your new joint. But about
half of all people who have knee replacement surgery say they don’t like the
feeling when they kneel. Patients “forget” they’ve had the
surgery. The most common reason for early failure is an infection.
Other causes include instability,
loosening, and wear and tear. Later failures are the result of persistent pain
or mechanical symptoms (the joint locks or gives out). For some, knee
replacements are inevitable due to genetic predisposition to arthritis. But you
can help prevent an arthritic knee from being so painful that you require
surgery by maintaining a healthy body weight and an active lifestyle. Try low
impact exercise to keep leg muscles strong. In addition, studies indicate there
may be hope for using stem cells to treat knee pain in the future.
Even
if you’re able to return to full normal after your surgery, you’ll need to mind
your artificial knee for the rest of your life. Avoid lifting anything more
than 20 pounds. That can stress the joint too much. Don’t jerk the leg with the
implant. Turn by taking small steps. Pivoting sharply -- your toes pointed in
one direction and your thigh and upper body in another -- can damage the
implant and wear it out sooner. Nearly one out of 10 people end up needing to
repair or replace their artificial knee. More than two-thirds of these
operations are done within the first year, usually because the joint gets
infected. Repeat surgeries that happen later more often involve a loose
implant, which can be painful or can leave your knee unstable. Always keep a
watch on your artificial joint. If you suddenly have pain, swelling, and
trouble moving it, call your surgeon.
Your
knee implant will almost always set off the airport metal detector. That can trigger
a hand pat-down screening by a Transportation Security Administration (TSA)
agent. If the security checkpoint has a full-body scanner, you can go through
that instead. You may still be searched a second time if the agents think they
see something suspicious on the screen. You can print and carry a small TSA
notification card to let the agent know you have an artificial knee, but this
will not always stop them from searching you again. You also can speed things
up by wearing clothes that easily let you reveal your surgical scar.
“At some point in
every person's life, you will need an assisted medical device - whether it's
your glasses, your contacts, or as you age and you have a hip replacement or a
knee replacement or a pacemaker. The prosthetic generation is all around us.” (Aimee Mullins) [i]
[i] Sources used:
·
“16 Things You Need to Know About Knee Replacement”
by Lauren Cahn
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